Workaholics4Hire.com

Location: Work At Home

We are seeking an energetic, well-rounded RN to work within Case Management with Optum’s Healthy First Steps Program. This Telecommuting Case Manager role can be located anywhere in United States. Requires RN in good standing in state of candidate’s residency.

Responsibilities for Case Managers include:

• Making outbound calls to assess members’ current health status
• Identifying gaps or barriers in treatment plans
• Providing patient education to assist with self management
• Interacting with Medical Directors on challenging cases
• Coordinating care for members
• Making referrals to outside sources
• Coordinating services as needed (home health, DME, etc)
• Educating members on disease processes
• Encouraging members to make healthy lifestyle changes
• Documenting and tracking findings
• Utilizing Milliman criteria to determine if patients are in the correct hospital setting
• Making ‘welcome home’ calls to ensure that discharged member receive the necessary services and resources

What makes your clinical career greater with [COMPANY NAME]? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you’ll open doors for yourself that simply do not exist in any other organization, anywhere.

Positions in this function include RN (with current licensure) that identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and pregnancy management activities across the continuum of utilizaton management (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes pregnancy case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members.

Generally work is self-directed and not prescribed.

•  Works with less structured, more complex issues.
•  Serves as a resource to others.

Positions in this function include RN (with current licensure) that identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN.

•   Generally work is self-directed and not prescribed.
•  Works with less structured, more complex issues.
•  Serves as a resource to others.

Requires current unrestricted RN licensure in applicable state.

Qualification

Requirements:

• Current, unrestricted RN license in the State of residency
• 2 plus years experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
• 2 plus years utilization management experience
• Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment

Additional Assets Preferred:

• Bachelor’s Degree
• OB experience
• A background in managed care
• Case Management experience
• Certified Case Manager (CCM)
• Milliman/Interqual experience
• Experience/exposure with discharge planning
• Experience in utilization review, concurrent review and/or risk management
• Strong organizational skills and multitasking abilities will be keys to success

[COMPANY NAME] helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At [COMPANY NAME], you will perform within an innovative culture that’s focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that’s greater than you’ve ever imagined.

How To Apply For This Work At Home Job

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